Samiya is an 8-year old South Asian female who has just been diagnosed with asthma which is
impacting upon her day-to-day life; she is struggling to run around in the playground with her
friends. Samiya didn’t really understand the information that her doctor had given to her and her
parents are worried she doesn’t understand the significance of not using her inhaler. Her parents say
that there are many times when Samiya has angry outbursts at home followed by periods of refusing
to speak to them when they ask her to use her inhaler. She doesn’t understand why she has to do
this when none of her friends do and she doesn't like to use her inhaler in front of others as she
worries about being different. The doctor recommended the use of a mobile phone App to Samiya’s
parents to help Samiya self-manage her condition. English is a second language for Samiya and her
family.
2500= 2750
1) What are the ‘issues’ you have identified – please clearly explain what they are
2) Drawing upon relevant health psychology theory, models and research, why are these issues
important in this particular case? What problems could they cause?
3) Using relevant health psychology theory, models and research, what advice would you
give/what would you recommend based on the issues identified?
a. Advice given should be in the context of the particular case study.
b. Advice can be for anyone relevant to the particular case (e.g. individual in the case, family,
friends, health care professionals etc.)
Samiya has been diagnosed with asthma, a long-term condition and is required to use her inhaler to
help her breathe more easily when symptoms appear. It can be defined as a condition where your
airways narrow and swell which can make breathing difficult. It can trigger coughing, wheezing and a
shortness of breath but can be treated using an inhaler (Bousquet et al, 2010). However, Samiya is
presenting issues as she is struggling to use her inhaler in front of others as she is only 8 years old
and worries about being different to her friends. A second issue Samiya is experiencing is also health
literacy as she does not really understand the information her doctor has given her. The third issue is
the worry it is causing for her parents which is resulting in angry outburst that Samiya presents at
home when her parents ask her to use her inhaler.
In the case study, Samiya’s is reluctant towards using her inhaler in front of her friends which can
lead to serious implications for her health (Tibosch et al, 2010). This presents the issue of asthma
stigma and how it is affecting Samiya’s medication use. A person is said to be stigmatised when their
single characteristic which is devalued by society, is used to represent the person (Goffman, 1963).
Asthma is associated with vulnerability and weakness especially when it comes to exercise (Spurrier
et al, 2000). Samiya does not wish to appear different as the case study states “she doesn’t like to
use her inhaler in front of others as she worries about being different” which implies that using her
inhaler in front of her friends causes social anxiety for Samiya as she does not want her peers to look
, at her differently and associate her inhaler use with vulnerability. This is an issue as the literature
suggests a link between asthma stigma and anxiety which could be causing Samiya’s reluctance to
use her inhaler (Ahmad & Ismail, 2015). Bruzzese et al (2009) conducted a study to examine the
relationship between self-reported social anxiety and asthma. They found that children with asthma
were more likely to report social anxiety especially in relation to exhibiting symptoms or taking their
medication in front of their peers. In addition, concerns with peer acceptance has been found to
decrease compliance with treatments that require taking medication in front of their peers
(Randolph et al 1998). This may be due to the way their peers would view them after finding out
about their diagnosis.
Therefore, research shows that the worries that Samiya is experiencing is common in individuals
with asthmatic symptoms as peers are a large part of their development and forming their
perceptions (Witvliet et al, 2010). Yet this can result in high levels of anxiety which can lead to less
use of her inhaler resulting eventually in asthma morbidity and limiting Samiya’s quality of life
(Cohen et al, 2003). This anxiety highlights on the importance of asthma stigma and how Samiya’s
perception of her peer’s reaction can affect her inhaler usage. The Common-Sense Model
(Leventhal., 1984) explains how perception can impact an individual’s medication use. The model
suggests that the individual’s perception of the health threat predict the response to it which can be
influenced by societies beliefs or in Samiya’s case her peer’s reaction. The perception of the illness
motivates the individual to select a coping strategy for the illness which for Samiya’s is not using her
inhaler to avoid peer rejection, which is what she believes the response to her illness stigma to be.
Samiya may have learned that peers reject those who are different by observing how other children
have been treated and so may believe that her peers may reject her in fear of her asthma or see her
as vulnerable due to the stigma around asthma (Miller & Wood, 1991). However, Shah et al (2001)
found that peers have been found to be an asset for companionship, understanding and support in
helping individuals manage their asthma. Therefore, by changing the mindset and perception Samiya
and her peers have about asthma and inhaler use, it could help decrease Samiya’s anxiety and
encourage her to use her inhaler.
Consequently, asthma is considered a stigma in society due to the lack of awareness around it and so
to help encourage Samiya to use her inhaler and reduce her anxiety, her peers could be targeted to
change how they perceive asthma which would make her feel more comfortable (Ahmed & Ismail,
2015). Therefore, a whole school workshop could benefit Samiya and her peers in understanding
what asthma is, which may encourage Samiya to feel comfortable using her inhaler. Mosler et al
(2020) conducted a workshop using the My Asthma in School (MAIS) intervention. The intervention
included a theatre workshop, games, an information booklet, and a short movie focusing on problem
